The axillary vein has been suggested as an alternate site for venous access to avoid the "subclavian crush phenomenon. " Many techniques have been used to access this structure. They include complicated anatomical landmarks, contrast venography, Doppler, and ultrasound. A simple technique using the basic anatomical landmark of the deltopectoral groove and a blind venous stick has been used successfully in 165 of 168 consecutive pacemaker and ICD procedures; there were only three failures. These required an alternate approach. With a thorough knowledge of the regional anatomy, the axillary vein can be safely used as a primary site of venous access.